Loyola University Chicago
Marcella Niehoff School of Nursing
Spring, 2014
Course Number and Title: GNUR 514 COMMON HEALTH PROBLEMS OF ADULTS/ OLDER ADULTS
Number of Credits: 3
Meeting Schedule: On-line lectures, in class exams on Thursdays 2/6/14, 3/20/14, 5/1/14
Marcella Niehoff School of Nursing, Room 0505, 3-5 pm
Faculty: Michael Egan, DNP, APN/FNP
Kristi Feutz, DNP, APN, FNP-BC
Cathlin Poronsky, PhD, APN, FNP-BC
Faculty Contact Information:
Dr. Egan: megan2@luc.edu , office hours by appointment
Dr. Feutz: kfeutz@luc.edu , office hours by appointment
Dr. Poronsky: cporonsky@luc.edu, office hours by appointment
Prerequisites: Advanced Physiology, Advanced Pharmacology, and Advanced Health Assessment
Co-requisites: N/A
Course Description: One course of a three-course sequence, GNUR 514 is designed to prepare the Nurse
Practitioner to assume responsibility for coordination and management of adult/older adult health care.
A major focus of the course is to prepare the student to assess and manage selected common health
problems of adults/older adults in primary care settings. Indications for collaboration, consultation,
and/or referral to other health care providers are emphasized as an integral part of the nurse
practitioner’s role. The accompanying practicum offers the student an opportunity to exercise critical
judgment and implement theoretical knowledge in the management of care of adults experiencing
common health problems.
Course Outcomes:
Upon successful completion of the course, the student will be able to:
1.
Describe the appropriate data necessary to assess the presenting health problems in
adults/older adults with common conditions.
2.
Utilize assessment data as a basis for determining an accurate problem list.
3.
Describe the pathophysiologic and psychosocial changes that occur in common health
problems of adults/older adults.
4.
Diagnose and manage adult/older adult health problems based on the knowledge of
clinical presentation, natural history of disease and micro/macro environmental factors.
5.
Evaluate the management outcomes of adult/older adult health care and revise plans
appropriately.
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6.
7.
8.
Recognize client problems that require collaboration and consultation or referral to
other members of the multidisciplinary health care team.
Apply knowledge of ethical and legal issues in the provision of primary health care
for adults/older adults.
Apply theoretical knowledge of the clinical presentation, assessment, and
management of common health problems to the analysis of case studies.
Teaching methods:
Think of this course as ‘meeting’ on Mondays. Each week the lectures, readings, and assignments should
be completed by Monday morning so that a new unit can then begin. Students are given learning
objectives and reading assignments for each week’s content. Evidence-based clinical practice guidelines
are included, and serve as essential resources for learning. Case studies and discussion questions are
used to help develop critical thinking skills. Students submit cases and participate in online discussion by
each week’s due dates and times.
There will be 3 types of assignments for this course: Individual case studies, group case studies, and
group discussions. Each block will contain a mix of these assignments.
1. There will be 3 individual case study assignments during the semester, one for each block of content.
Case studies should be submitted as a Word document attachment via Sakai using the Assignment
button by 9 am on the assignment due date. Faculty will review, evaluate, and respond with individual
feedback for each assignment. There is a 10% penalty for each day that the assignment is late. If the
assignment is greater than 7 days late, a grade of 0 will be assigned. See the “Guidelines for Case Study
Assignment” in this syllabus.
2. There will be 3 group case study assignments, one for each block of content. Each student is assigned to
a small group in the Discussion forum on Sakai. Each group member is expected to actively contribute to
development of the group case study. One word document for the group should be submitted in the
group folder for that unit on Sakai by 9 am on the assignment due date. Faculty will review, evaluate,
and respond with feedback to the group folder on Sakai for each group assignment. Students will
evaluate each group member’s participation and submit that to faculty as a word document via Sakai using
the Assignment button by 9 am on the assignment due date. There is a 10% penalty for each day that
the assignment is late. If the assignment is greater than 7 days late, a grade of 0 will be assigned. See
the “Guidelines for Case Study Assignment” in this syllabus.
3. There will be 2 group discussion assignments. Each student is assigned to a small group. All students
will be expected to participate through asynchronous, threaded discussions using Sakai. The purpose of
this assignment is to foster discussion. Each student’s initial response to the discussion questions should be
posted no later than Thursday following the Monday class lecture ,(see course calendar for dates). Each
student should post a response to at least 2 members of their group at least 24 hrs. prior to the close of the
discussion on the following Monday. See the “Guidelines for Online Discussion Forum” in this syllabus.
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Evaluation: The 514 course covers material essential to advanced practice, and requires a minimum of a
B- grade. Students earning less than a B- must repeat the course before progressing in their APN
specialty program.
EVALUATION: STUDENTS TAKING THE COURSE FOR THE FIRST TIME
Test #1
20%
Test #2
20%
Test #3
20%
Case Studies (6)
30% (5% EACH)
Group Discussion Participation (2)
10% (5% EACH)
Students who must repeat this course do not repeat case studies and discussions instead, the course
grade is based on 4 exams as noted below.
EVALUATION: STUDENTS REPEATING THE COURSE
Test #1
25%
Test #2
25%
Test #3
25%
Final cumulative exam 25%
GRADE SCALE
A
100-94,
C+
83-80,
A- 93-92,
C 79-77,
B+ 91-89
C-76-75,
B 88-86,
D+74-72,
B-85-84
D 71-69,
F 68 and below
Required course materials:
Cash, J. C. & Glass, C. A. (2011). Family practice guidelines (2nd ed.) New York: Springer Publishing.
ISBN 978-0-8261-1812-7.
Dains, J.E., Bauman, L. C. & Scheibel, P. (2012). Advanced health assessment & clinical diagnosis in
primary care (4th ed.). St. Louis: Mosby Elsevier. ISBN: 978-0-323-07417-9.
Dunphy, L. M., Winland-Brown, J. E., Porter, B. & Thomas, D. J. (2011). Primary care: The art and science
of advanced practice nursing (3rd ed.). Philadelphia: F. A. Davis. ISBN 978-0-8036-2255-5.



Pharmacology text used for GNUR 413
Health Assessment text used for GNUR 409
Student selected text of Laboratory Tests/Diagnostic Procedures or recommended Lab text
below.
Recommended course materials:
NOTE: The Sanford Guide and Differential Diagnosis of Common Complaints are both highly
recommended texts. Both of these texts will be very useful for students in clinical practicum as well as
in this course.
Gilbert, D., Moellering, R., & Eliopoulos, G. & Sande, M. (2013). The Sanford guide to antimicrobial
therapy (43rd ed.) Dallas, Tx: Antimicrobial Therapy, Inc.
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Print or mobile edition available from: http://www.sanfordguide.com/publications/the-sanford-guideto-antimicrobial-therapy
Habif, T. P., Dinulos, J. G. H., Zug, K. A., Chapman, S., & Campbell, J. L. (2011). Skin disease: Diagnosis and
treatment (3rd ed.). St. Louis: Elsevier Mosby. 978-0-323-07700-2
Pagana, K. D. & Pagana, T. J. (2010) Mosby's manual of diagnostic and laboratory tests (4th ed.) St. Louis:
Mosby/Elseveir. ISBN-13: 978-0-3230-5747-9
Seller, R.H. (2012). Differential diagnosis of common complaints (6th ed.). Philadelphia: W.B.
Saunders. ISBN: 13: 978-1-4557-0772-0. (Very good text for differential diagnosis)
U.S. Department of Health and Human Services, Public Health Service. (2010) Healthy people 2020:
National health promotion and disease prevention objectives. Washington, D.C.:
http://www.healthypeople.gov/2020/default.aspx
Course Evaluation Expectation: It is a professional expectation that all students participate in course
evaluations to guide ongoing program improvement.
Academic integrity statement: Academic honesty is an expression of an ethic of interpersonal justice,
responsibility and care applicable to Loyola University faculty, students and staff, which demands that
the pursuit of knowledge in the university community be carried out with sincerity and integrity. Refer
to the MSN/DNP Handbook located on Sakai in the “SON Info for MSN Students” Course for a
description of the Academic Integrity Policy.
COURSE POLICIES
1. Students are required to take exams on campus on the dates/times scheduled on the course calendar.
There are no online exam options available for this course.
2. Students are required to submit assignments on the dates/times assigned on the course calendar.
Late submission of assignments will result in lowering of the grade for that assignment by 10 points for
each day that the assignment is late. If the assignment is greater than 7 days late, a grade of 0 will be
assigned unless special arrangements are made in advance between the student and faculty.
COURSE ORGANIZATION:
This course is arranged in 11 modules. Each module is one week in length. To accommodate varying
schedules, the modules will be made available in blocks. Block 1 has Modules 1-3 and will be opened by
January 13, 2014. Block 2 will open on February 6th and will include Modules 4-7. Block 3 contains
Modules 8-11 and will open on March 20th. Thus, students can work ahead of the weekly timeframe if
desired. See the course calendar at the end of this syllabus.
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CONTENT OUTLINE: Evaluation and management of adults and older adults with the following
problems:
Block 1
Overview of Health Promotion, Disease Prevention, Smoking Cessation, and Obesity
Levels of prevention and risk reduction
Immunization recommendations
Screening for disease
Smoking Cessation
Obesity
Dermatologic Problems
Skin lesions, dermatitis, acne, psoriasis
Bacterial, fungal, viral infections
Allergic Reactions: drug, insect stings and contact (poison ivy)
Infestations; hair/nail disorders
Mental Health Problems
Depression
Anxiety Disorders
Grief
Addictions
Sleep Disorders
Eating Disorders
Block 2
HEENT Problems
Headache
Common ear conditions
Allergy, ABRS
Pharyngitis, mononucleosis
Common eye conditions
GI Problems
Abdominal symptoms
Acute GI conditions
GERD
PUD
IBD, IBS
GU Problems
Proteinuria, hematuria, UTI
Renal Disease: Acute renal disease, ESRD
Block 3
Respiratory Problems
Cough, Acute Bronchitis
Pneumonia
Asthma
Tuberculosis
Cardiovascular Problems
Hypertension, Hyperlipidemia and CHD, Chest pain
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GNUR 514 Common Problems in Adults/Older Adults:
Guidelines for Case Study Assignments
The individual and group case study assignments are intended to help students apply the information
The individual and group case study assignments are intended to help students apply the information
from the readings and lecture to a real patient situation. Although APA format is not necessary,
graduate level writing skills are expected. This assignment does not require a multipage paper. We are
looking for your application of the content to the scenario, demonstration of critical thinking and
problem solving skills, and your rationale to support your answer.
For each question in the case study, your written response should begin with the question stated first,
then followed by your response in well written sentences with appropriate grammar and accurate
spelling. The questions should be answered using information from the lecture and assigned readings. If
your responses to the assignments are prepared from the lecture and assigned readings for that
module, then citation of sources is not required. IF additional sources are used and/or your answer
differs from the standard of care you have learned in the readings, then your answer should be cited
appropriately. As a reminder, sources that are acceptable include: Articles published in advanced
practice nursing or clinical medicine peer reviewed journals, or primary care texts published within the
past five years, or evidence based practice guidelines. Research focused journals may not be in step
with current clinical practice and are therefore not recommended for this assignment. Web based
sources (such as Wikipedia, Medscape, etc.) are not acceptable. For pharmacology related information
Pepid or Epocrates are acceptable sources.
Some tips for completing this assignment include: Be sure to focus on all history components instead of
only the chief complaint. View the patient as a whole, pay attention to age, gender, and current
medications, past medical history, family history, and social history. Be specific about what you would
include in the treatment plan.
Your treatment plan should be guided by the literature. Be sure to look at all of the readings for the
module when writing up the case study. While we are looking for conciseness, we are also looking for
thoroughness and completeness in your answers to each question. Lab testing should be connected to a
diagnosis that is included in the assessment. All medications need to be connected to a diagnosis that is
included in the assessment. The name of the medication, strength, quantity to be dispensed, and
patient instructions need to be included for all prescription medications, i.e., written as a prescription.
Each case study is worth 20 points. Scoring for the assignments will be based on accuracy, thoroughness,
and completeness of answers to the questions. Late submission of assignments will result in lowering of
the grade for that assignment by 10% (2 points) for each day that the assignment is late. If the
assignment is greater than 7 days late, a grade of 0 will be assigned unless special arrangements are
made in advance between the student and faculty. The individual case study should be submitted via
the Assignment button on Sakai.
Group Case Studies: Each group will work together using email, the discussion board, phone, or face to
face meetings to answer the case study questions and develop one document for the group. Grading for
the group case studies will follow the same criteria with one exception. The group’s final document will
equal 90% (18 points) and 10% (2 points) will be based on each student’s peer evaluated participation.
See “Group Members Participation Evaluation for Case Studies” information on the following pages.
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The group case study should be submitted as an attachment to the group discussion folder on Sakai for
that week’s content. The participation evaluation should be submitted on the same date via the
Assignment button on Sakai. The student’s peer evaluation should include a self-evaluation score for
each criteria. Missing peer evaluations and late submission of peer evaluations will result in a partial
loss of points for this component of the assignment.
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Instructions:
1. Use these rubrics to fill in the ratings table (p. 8) for all team members, including yourself. Try
to keep the ratings for each of the criteria distinct. If a team member is marginal or outstanding
in one area, do not let that affect your ratings on other areas. Whole numbers (1,2, 3, 4) should
be used.
2. After you have completed the ratings on the scale shown on page 8, submit this to course
faculty using the Assignment button on Sakai. Make sure your rating is a fair summation, in your
view, of the team member’s contribution. That will be the rating used for grading purposes.
3. Add comments that give a clearer picture of the value added by each team member. Ideally, the
contents of this report should show how the complementary contributions from different
people came together to make the case study better/worse.
4. NOTE: Access to your participation evaluation document is limited to faculty only. This will not
be visible to members of your group.
Criteria
Unacceptable = 1
Quality of work
Quantity of
work
Work was not
usable, or
regularly needed
major rework
Did hardly any
work.
Initiative,
creativity,
Expertise,
leadership
Made practically
no contributions
in any of these
areas.
Dependability
and meeting
commitments
Could not be
counted on at all.
Interaction,
supporting
other team
members,
sharing
information
Team meetings:
participation,
punctuality
Was a major
problem to
interact and work
with.
Often missed
meetings, little
participation in
discussions and
activities
Marginal = 2
Very good = 3
Outstanding = 4
Work often had
flaws and
omissions that
needed fixing
Contributed OK,
somewhat less
than their share.
Mostly passive
participant,
occasionally had
interesting &
useful inputs.
Usually met
commitments.
Needed some
reminders or
follow-up.
Some interaction
problems,
unhelpfulness, or
failure to
communicate.
Generally high
quality of work,
only occasional
fixes needed
Worked hard,
carried their share
of the load.
Significant source
of ideas and
energy, took
initiative as
needed.
Conscientious
about
commitments.
Very dependable.
Amazingly good
output, well beyond
expectations
Interacted well
with others,
helpful, flexible,
pleasure to work
with.
Went out of the
way to help
teammates and
enable them to
contribute.
Participation
spotty: blew off
some meetings,
not always
participative
Participated fully in
all team activities,
nearly always on
time
Drew out others
and ensured that
everyone
participated.
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Considerable extra
work, more than
their share.
Ideas / energy /
leadership provided
were a huge reason
for team success.
Went out of the
way to pick up slack
for others who miss
commitments.
Group Number:
Student Evaluator:
Case Study:
Group member
ONLY WHOLE NUMBERS (1-4 )SHOULD BE USED
Name1
Name2
Name3
Quality of work
Quantity of work
Initiative,
creativity,
Expertise,
leadership
Dependability and
meeting
commitments
Interaction,
supporting other
team members,
sharing
information
Team meetings:
participation,
punctuality
Student Evaluator
Comments /
Feedback
(Make sure to
identify/appreciate
the positives, as
well as pointing
out areas for
improvement)
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Name4
Name5
Yourself
Guidelines for Online Discussion Forum
We will be interacting with each other through asynchronous, threaded group discussion discussions on
Sakai. Each student will be assigned to a small group. The term “asynchronous” means the occurrence
of processes at different times -- and in our situation different places. The threaded discussion process
will allow you to think critically about the material, respond as an individual, and ultimately engage in
constructive dialogue with others. Think of the threaded discussion space as our "classroom." In a
physical classroom, we would ask questions, discuss topics, and share comments. Although we cannot
be in the same physical space, we can still interact and have a sense of community through threaded
discussions. Students should prepare by reading the module objectives, listening to the narrated power
point lecture, completing the reading assignment, and then post their responses to the discussion
questions.
Guidelines for Class Discussion: To allow you and your classmates’ time to discuss the questions for the
learning module, here are the ground rules for the threaded discussion process. Our class meets on
Mondays. You will be required to post at least twice a week for each week that class discussion
questions are assigned. You should first submit an initial post and then follow up with a response post.
Initial Post:
The initial post is your answer to the discussion questions for the assignment in the week’s
learning module. This should be posted in the threaded folder by 9 a.m. on the Thursday following
Monday’s class lecture. Your responses to group are due by 9 a.m. on the following Monday
(See the course schedule on pages 9-10 for due dates).
Response Post:
This is your response to at least two other classmates original posting. Read your group
members’ posts and then refer to information from other posts in the discussion. You can ask
questions; clarify a point, or reinforce statements or answers that you agree with. If you disagree
or have a different point of view, state this politely, but clearly. Your responses should be
substantive and reflect knowledge of the assigned material. Responses such as “good job” or “I
agree” will not be awarded points. Responses should be posted in a timely manner in order to
stimulate discussion; waiting until the deadlines on Thursday or Monday to post will result in loss
of points.
It is strongly recommended that you compose the postings on a word processor (checking for spelling,
grammar, etc.). You can then simply cut and paste it into the body of the posting. Response postings
should be concise and do not need to be excessive in length. Each discussion is worth 20 points. In order
to earn the full point value for the assignment postings need to be completed by the Thursday and
Monday deadlines.
Group Discussion Forum Participation Scoring
Scoring for the discussion forums will be based on accuracy, thoroughness, and completeness of
answers to the discussion questions. Frequency and timeliness of responses as well as substance of
responses to peers will be evaluated.
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Note:
When posting use titles for posts and keep each post in the threaded discussion folder for that week’s
topic. For example, when responding to the discussion questions for the respiratory module, all
responses should be posted into that folder. Your post should include the module title, your name and
the topic of your posted discussion question. For example: “COPD, question 2 Mary Jones.” This makes it
much easier for everyone to find and refer to specific posts in the discussions.
What if I need help from my instructor?
If you have questions about any of the assignments for this course, you can ask them within a threaded
discussion entitled, "Questions for Instructor." This is a space where you can ask questions to clarify the
assignment. We will respond within this space to the whole group. We would prefer that you ask
content related questions here rather than emailing them. This lets others in the class benefit from
reading your questions and the answers. It is likely that your question will be one that someone else has
also has been thinking about!
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COURSE SCHEDULE Spring 2014
Mondays/Thursday Exams
Week 1:
1/13/14
Health promotion, Health Maintenance, Disease Prevention, Obesity,
Group Case Study: Submit by 9 am 1/20/14
Week 2:
1/20/14
Dermatologic Problems
Individual Case study submit by 9 am 1/27/14
Week 3:
1/27/14
Mental Health Problems
Group discussion: Post initial response by 9 am 1/30/14; final response by 9 a.m. 2/3/14
Week 4: Thursday, 2/6/14, EXAM 1, Room 0505, 3 pm
Week 5:
2/10/14
HEENT Problems
Group Case study: submit by 9 am 2/24/14
Week 6:
2/17/14
Eye
No assignment
Week 7:
2/24/14
Gastrointestinal Problems
Individual case study: submit by 9 am 3/10/14
Week 8: 3/3/14 Spring Break: No Class
Week 9:
3/10/14
Genitourinary Problems
Group discussion: Post initial response by 9 am 3/13/14; final response by 9 a.m. 3/17/13
Week 10: Thursday, 3/20/14 EXAM 2 Room 0505, 3 pm
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Week 11:
3/24/14
Pulmonary Problems I
Pneumonia
Individual Case Study: Submit by 9 a.m. 4/7/14
Week 12:
3/31/14
Pulmonary Problems II
Asthma
No assignment
Week 13:
4/7/14
Cardiovascular Problems I
Group Case study: submit by 9 a.m. 4/21/14
Week 14:
4/14/14
Cardiovascular Problems II
No assignment
Week 15:
NO ASSIGNMENT
Week 16:
Thursday, May 1st, EXAM 3, Room 0505, 3 pm
(Students repeating this course: Final Cumulative Exam Tuesday, May 6 at 3 pm)
Revised 12/31/13 CBP, KF, ME
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